Study of ‘nonstress test at admission’ and its corelation with maternal and fetal outcome

Abstract

Introduction: Non stress test (NST) is the most widely used test for assessment of fetal health and reflects oxygenation of brain. NST is usually recommended after 30 to 32 weeks of the pregnancy. The false negative rate of NST (reactive NST in a fetus who actually is in distress) is 3.2/1000 which is very low and thus NST is considered as a good predictor of fetal health. Objectives: To evaluate the “NST at admission” in all the admitted women > 32 weeks of gestation and to correlate it with type of labour and mode of delivery and maternal and neonatal outcome. Materials and methods: This prospective study was conducted on all the pregnant women only at > 32 weeks of gestation admitted to Dayanand Medical College and Hospital (DMCH), Ludhiana from 1/1/2011 to 31/12/2011. Non stress test was done in all women using TOCODYNAMOMETER for 20 minutes and was extended to next 20 minutes in case of inconclusive NST. Both the mother and neonate were followed up till discharge from hospital. The data was analysed statistically using T test for quantitative variables and Chi square/Z test for qualitative variables. Results: In 228 women, 233 NSTs (5 twins) were done and 24 NSTs needed 20 minutes extension to reach to conclusion.179 (76.82%) NST were reactive while 54 (23.18%) were non reactive. Women admitted with reactive NST had significantly higher vaginal delivery rates i.e. (39.78% v 11.54%). Operative delivery in non reactive NST group was significantly higher than reactive NST group, i.e., (88.46% v 60.22%). All 233 babies were born alive irrespective of the NST status and 47.21% (110) required NICU admission. Conclusion: The ‘NST at admission’ is a simple method and is easy to perform for assessing fetal status antenatally and its reactivity assures good maternal and fetal outcome while non reactivity increases the chances of operative delivery and NICU admission.